| Doctor Name: | NNAMAKA SHAUN UGEZENE |
| NPI Number: | 1053781989 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSNPM |
| License Number: | |
| Business Practice Address: | 11776 Mariposa Rd #103 Hesperia, CA - 923451622 |
| Business Phone Number: | 7609562462 |
| Business Fax Number: | |
| Mailing Address: | 11776 Mariposa Rd, #103 HESPERIA |
| State: | CA |
| Postal Code: | 923451622 |
| Phone Number: | 7609562462 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2015 |
| NPI Last Update Date: | 11/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |